Why Asplenic Patients Should Not Take Care of the Neighbour's Dog? A Fatal Course of Capnocytophaga canimorsus Sepsis.

Capnocytophaga canimorsus (CC) belongs to the family Flavobacteriaceae which physiologically occurs in the natural flora of the oral mucosa of dogs and cats. In patients with a compromised immune system, CC can induce a systemic infection with a fulminant course of disease. Infections with CC are rare, and the diagnosis is often complicated and prolonged. We describe a patient with a medical history of prior splenectomy who presented with an acute sepsis and disseminated intravascular coagulation (DIC) and was initially treated on Waterhouse-Friderichsen syndrome (WFS). After the patient had died despite forced treatment in the intermediate care unit, the differential diagnosis of CC was confirmed by culture of blood smears. Later on, a retrospective third-party anamnesis revealed that the patient had contact to his neighbour's dog a few days before disease onset. In conclusion, patients with CC infection can mimic WFS and therefore must be included in the differential diagnosis, especially in patients with a corresponding medical history of dog or cat bites, scratches, licks, or simple exposure.

Advanced patient age at diagnosis of diffuse large B-cell lymphoma is associated with molecular characteristics including ABC-subtype and high expression of MYC.

The incidence of diffuse large B-cell lymphoma (DLBCL) increases with age being patient age at diagnosis an adverse prognostic factor. However, elderly patients are often underrepresented in common studies. To investigate the effect between age and biological characteristics in DLBCL, we analyzed data of 1534 patients encompassing all adult age groups, enriched for the age ≥75 years. Follicular lymphoma (FL) grade 3B with histopathological characteristics of DLBCLs were included. Gender, centroblastic cytology, FL grade 3B morphology, CD10 expression, and ABC/non-GCB-subtype were significantly associated with age after correction for multiple testing and after adjusting for cohorts. Analysis of a subgroup points towards an association of MYC expression with age. Our data indicate that biological features of DLBCL and FL grade 3B are associated with increasing age among adult patients. The prevalence of the ABC/non-GCB-subtype in elderly patients suggests that therapies targeting this molecular subtype should be specifically explored in this subgroup.